1
|
Ma S, Knapp P, Galdas P. 'My sexual desires, everything, my normal life just stops'; a qualitative study of male sexual health in inflammatory bowel disease. J Clin Nurs 2024. [PMID: 38797921 DOI: 10.1111/jocn.17292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
AIM To describe and interpret the sexual health experiences of men with IBD. DESIGN Interpretive qualitative study. METHODS In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis. RESULTS Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals. CONCLUSION Inflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention. REPORTING METHOD Reporting follows the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.
Collapse
Affiliation(s)
- Sara Ma
- School of Science, Technology & Health, York St John University, York, UK
- York and Scarborough Teaching Hospital NHS Foundation Trust, York, UK
- Department of Health Sciences, The University of York, York, UK
| | - Peter Knapp
- Department of Health Sciences, The University of York, York, UK
- Hull York Medical School, York, UK
| | - Paul Galdas
- Department of Health Sciences, The University of York, York, UK
| |
Collapse
|
2
|
Wang Y, Liu J, Zhou Y. Experience of Disease Acceptance in Chinese Patients with Newly Diagnosed Crohn's Disease: A Descriptive Qualitative Study. Patient Prefer Adherence 2023; 17:2523-2534. [PMID: 37849616 PMCID: PMC10577251 DOI: 10.2147/ppa.s429663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023] Open
Abstract
Background High levels of disease acceptance are important predictors of improved psychological well-being, treatment outcomes, and enhanced quality of life. Relatively few studies have focused on the process of disease acceptance in patients with Crohn's disease (CD), particularly those who are newly diagnosed. Purpose To explore the disease acceptance process in newly diagnosed CD patients. Patients and Methods A descriptive qualitative approach was employed. Sixteen CD patients from 2 tertiary hospitals in Hangzhou, Zhejiang were recruited through purposive sampling using a maximum variation strategy. Semi-structured interviews were conducted. The interviews were transcribed verbatim and analysed using conventional content analysis. Results Five phases of the psychosocial process of the "acceptance journey" of newly diagnosed CD patients emerged from the data analysis: (1) praying for the illness to not be CD; (2) not being able to accept CD; (3) having to accept CD; (4) knowing that CD should be acceptable; and (5) starting to accept CD. Patients at the stage of "starting to accept CD" are more proactive and motivated to face the disease, and their overall acceptance of the disease is higher than that of the previous stages. However, by the end of the interview, 2 patients remained at the stage of "having to accept CD", and 3 patients remained at the stage of "knowing that CD should be acceptable". Two patients entered the stage of "starting to accept CD" and then reverted back to one of the previous stages. Conclusion The "acceptance journey" of newly diagnosed CD patients is dynamic, individual and reversible. Traditional Chinese cultural values such as respect for authority, the philosophy of wu-wei and family responsibility contribute to the acceptance of CD in Chinese patients. Hence, there is a need to provide early and culturally tailored psychological support or interventions according to the stages of acceptance.
Collapse
Affiliation(s)
- Ying Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Jinghan Liu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| |
Collapse
|
3
|
Chen L, Zhou Y. The symptom experience of newly diagnosed Chinese patients with Crohn's disease: A longitudinal qualitative study. J Adv Nurs 2023; 79:3824-3836. [PMID: 37243391 DOI: 10.1111/jan.15721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
AIMS To longitudinally explore the symptom experience of Chinese patients with Crohn's disease within the first year following their diagnosis. DESIGN A longitudinal qualitative study. METHOD Eighteen newly diagnosed Chinese patients with Crohn's disease were recruited through purposive sampling. Semi-structured interviews were conducted at four time points: soon after diagnosis, 3, 6 and 12 months post-diagnosis. Data were collected between January 2021 and February 2022. Conventional content analysis was used for data analysis of each time point. Afterwards, the data of each time point were compared longitudinally. COREQ checklist was followed. RESULTS Three themes and eight sub-themes were formed through analysis: feelings towards symptoms (symptoms make me feel uneasy, symptoms make me feel inferior and symptoms make me feel helpless); acceptability of symptoms (difficult to accept, have to accept, be able to accept); functions of symptoms (assessing disease conditions and treatment effects, warning of disease management). CONCLUSIONS Overall, the negative emotions related to symptoms gradually decreased over time, and the patient's acceptance of symptoms increased within the first year following diagnosis. In addition, when the disease was in remission after treatment, the warning function of symptoms gradually weakened. IMPACT The process of how patients accept their symptoms found in this study provides a basis for nurses to improve patients' acceptance of symptoms and reduce their symptom-related negative emotions. This study also emphasizes the phenomenon that patients gradually ignore some symptoms with their increased acceptance level, which warrants additional health education to strengthen their awareness of self-management. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to design or undertake this study. Patients contributed only to the data collection and member checking.
Collapse
Affiliation(s)
- Lingxi Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| |
Collapse
|
4
|
Wang YT, Tang YQ, Xu JY, Bian XM. The Disease Experience of Women with Granulomatous Lobular Mastitis. A Qualitative Interview Study. J Inflamm Res 2023; 16:4347-4361. [PMID: 37791120 PMCID: PMC10544261 DOI: 10.2147/jir.s419347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Background The incidence of granulomatous lobular mastitis (GLM) is increasing year by year, and the breast wounds of women patients with GLM can develop into abscesses, fistulas, sinuses, and sometimes orange-like degeneration similar to malignant tumors, which seriously affects the quality of life of women patients with GLM. In China, breast wounds in women patients with GLM have not been better managed. Therefore, the purpose of this study is to explore the disease experience of women patients with GLM, to provide a basis for the development of precise intervention and support strategies for women patients with GLM, and to further improve the quality of nursing management and enrich the research types of GLM. Methods In this study, 10 cases of GLM women patients from a tertiary hospital in Hangzhou, Zhejiang Province were selected by purposive sampling. After obtaining the informed consent of GLM women patients, semi-structured interviews were conducted with GLM women patients using the interview outline to collect qualitative data. The interview was recorded, transcribed verbatim in the local language, and then translated into English, and the content analysis method was used to analyze the data. The Consolidated Criteria for Reporting Qualitative Research (CORE-Q) checklist follows the report 's findings. Results Our study identified six themes: (a) Perception of the disease, (b) Emotional discomfort (c) Variety of changes (d) Lack of specific skills (e) Coping strategies adopted to rebuild health, (f) Expectation. Conclusion The experience of women with GLM is characterized by diversity and specificity. After experiencing physical trauma, most patients use support systems to change negative attitudes and rebuild physical and mental health. Family, hospital and society should be fully linked to strengthen the prevention of GLM and the popularization of nursing management knowledge; nurses should provide targeted nursing services. Nursing leaders should improve the medical security system, broaden the medical channels, and reduce the pain experience and pressure of patients.
Collapse
Affiliation(s)
- Yan Ting Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Ya Qin Tang
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jia Yuan Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xue Mei Bian
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| |
Collapse
|
5
|
Chen L, Wang D, Zhou Y. The Illness Experiences of Chinese Adolescent Patients Living with Crohn Disease: A Descriptive Qualitative Study. Gastroenterol Nurs 2023; 46:95-106. [PMID: 36882914 DOI: 10.1097/sga.0000000000000723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/18/2022] [Indexed: 03/09/2023] Open
Abstract
The purpose of this qualitative study was to explore the illness experience of adolescent patients with Crohn disease and describe the impact of the disease on the everyday lives of these individuals within the Chinese social and cultural context to provide references for targeted interventions for the healthcare team. A descriptive qualitative design was adopted. Purposive sampling was used to select Chinese adolescent patients with Crohn disease to participate in face-to-face in-depth interviews. Data analysis was performed using the conventional content analysis method. Through the analysis of data from 14 adolescent patients with Crohn disease, four themes were formed: (1) I am different from others, (2) I am a burden to my parents, (3) I want to be the master of my own body, and (4) I grow up suffering from illness. Healthcare providers should offer more psychological support to adolescent Crohn disease patients and advise parents to shift more attention to the mental health of their children.
Collapse
Affiliation(s)
- Lingxi Chen
- Lingxi Chen, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Danyan Wang, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Yunxian Zhou, PhD, is Professor, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Danyan Wang
- Lingxi Chen, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Danyan Wang, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Yunxian Zhou, PhD, is Professor, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yunxian Zhou
- Lingxi Chen, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Danyan Wang, MSN, is RN, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Yunxian Zhou, PhD, is Professor, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| |
Collapse
|
6
|
Simeone S, Mercuri C, Cosco C, Bosco V, Pagliuso C, Doldo P. Enacted Stigma in Inflammatory Bowel Disease: An Italian Phenomenological Study. Healthcare (Basel) 2023; 11:healthcare11040474. [PMID: 36833009 PMCID: PMC9956300 DOI: 10.3390/healthcare11040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 02/09/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic disease of the gastrointestinal tract that has a profound impact on the quality of life of those afflicted with it. The scientific literature shows how the quality of life of people with IBD influences and is influenced by the clinical manifestations of the disease. Strongly connected with excretory functions, which have always been taboo in society, these clinical manifestations can lead to stigmatizing behaviours. The purpose of this study was to understand the lived experiences of the enacted stigma of people with IBD through Cohen's phenomenological method. Two main themes (stigma in the workplace and stigma in social life) and one subtheme (stigma in love life) emerged from the data analysis. The data analysis revealed that stigma is associated with a multitude of negative health outcomes for the people targeted by it and can add to the already complex physical, psychological and social burdens endured by people with IBD. Having a better understanding of the stigma attached to IBD will facilitate the development of care and training interventions that can improve the quality of life of people suffering from IBD.
Collapse
|
7
|
Barned C, Fabricius A, Stintzi A, Mack DR, O'Doherty KC. "The Rest of my Childhood was Lost": Canadian Children and Adolescents' Experiences Navigating Inflammatory Bowel Disease. QUALITATIVE HEALTH RESEARCH 2022; 32:95-107. [PMID: 34818940 DOI: 10.1177/10497323211046577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Children and adolescents with Inflammatory Bowel Disease (IBD) face significant and unique challenges related to their condition. The aim of this study was to better understand some of these challenges, and to explore how Canadian youth respond to them. We interviewed 25 pediatric patients with IBD, ranging in age from 10-17, to find out about their illness experiences. Using a thematic analysis, we discerned three themes: challenges related to diagnosis, making sense of change, and navigating sociability. Taken together, they paint a picture of young people facing great uncertainty prior to diagnosis, pronounced changes to selfhood as they make lifestyle adjustments, and facing difficulties with the implications of reduced sociability because of their disease. We conclude by providing recommendations for the development of resources aimed at helping newly diagnosed pediatric patients navigate these issues.
Collapse
Affiliation(s)
- Claudia Barned
- UHN Bioethics Program, 7989University Health Network, Toronto, Canada
- Pragmatic Health Ethics Research Unit, 5598Institut de recherches Cliniques de Montreal, Montreal, Canada
| | - Alexis Fabricius
- Department of Psychology, 3653University of Guelph, Guelph, Canada
| | - Alain Stintzi
- Ottawa Institute of Systems Biology and Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, 6363University of Ottawa, Ottawa, Canada
| | - David R Mack
- Children's Hospital of Eastern Ontario (CHEO) IBD Centre and Department of Pediatrics, 27338University of Ottawa, Ottawa, Canada
| | | |
Collapse
|
8
|
Demir B, Bulbuloglu S. Perceived body image and distress after liver tansplantation in recipients. Transpl Immunol 2021; 69:101483. [PMID: 34688881 DOI: 10.1016/j.trim.2021.101483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study's aim was to determine the relationship between the perception of self-body image and the level of distress in patients who had liver transplantation surgery. METHOD This study was performed as a descriptive and cross-sectional study with the attendance of 120 liver transplant patients hospitalized in the liver transplant center of a training and research hospital. Self-body image was measured based on the Body Image Questionnaire (BIQ) on a scale of 40 (lowest) to 200 (highest) with the optimal BIQ score of 135-200. The level of distress was evaluated by the Distress Thermometer (DT) on a scale of 0 (None) to 10 (High). The data analysis was performed with the IBM Statistical Package for the Social Sciences Statistics 25. RESULTS According to the data attained, 35.8% of the patients were 55 years old or older, 56.7% were male, and 61.7% were married. The mean BIQ score among all tested patients was 81.85 ± 27.31, and this was considered as a low level of self-image. The mean DT score of the patients was 5.45 ± 2.72, which indicated relatively high levels of distress in the transplant recipients. Comparing these two values together (BIQ + DT) by regression analysis, we found a moderate negative relationship between self-body image (BIQ) and distress (DT) in the patients (r: -0.391, p < 0.001). Accordingly, when the distress levels of the patients decreased, their perceptions of self-body image increased. CONCLUSION Even if their liver transplant operation is successful, the problems of the recipients after transplantation do not completely disappear. Liver transplant recipients should be helped in coping with their condition effectively. Patients undergoing liver transplantation should be provided with psychosocial and emotional support.
Collapse
Affiliation(s)
- Bilsev Demir
- Division of Surgical Nursing, Nursing Department, Health Sciences Faculty, Malatya Turgut Özal University, Malatya, Turkey.
| | - Semra Bulbuloglu
- Division of Surgical Nursing, Nursing Department, Health Sciences Faculty, Istanbul Aydın University, Istanbul, Turkey.
| |
Collapse
|
9
|
Muse K, Johnson E, David AL. A Feeling of Otherness: A Qualitative Research Synthesis Exploring the Lived Experiences of Stigma in Individuals with Inflammatory Bowel Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158038. [PMID: 34360327 PMCID: PMC8345596 DOI: 10.3390/ijerph18158038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022]
Abstract
Inflammatory bowel disease (IBD) consists of Crohn’s disease and ulcerative colitis, chronic conditions involving inflammation and ulceration of the gastrointestinal tract. Individuals with IBD may be susceptible to experiencing health-related stigma: experienced, perceived, or internalised social exclusion, rejection, blame, or devaluation resulting from negative social judgements based on the disease. This qualitative research synthesis draws together findings from 38 studies describing lived experiences to develop a unified interpretative account of the experience of stigma in IBD. Analysis developed two categories: ‘The IBD journey’ explores the dynamic ways in which having IBD impacted on individuals’ self-identity and ‘a need to be understood’ examines the tension between wanting to be understood whilst feeling their true experiences needed to be hidden from or were misjudged by the social sphere. The overarching concept ‘feeling of otherness’ highlights that, rather than a static, binary experience, individuals moved across a continuum ranging from the excluding experience of feeling stigmatised and othered, to the inclusive experience of integration. Individuals fluctuated along this continuum across different physical, social, and health contexts. Psychological adjustment to IBD, drawing on experience of adaptive coping, and reconnecting with valued others through illness disclosure strengthened stigma resistance during more challenging times.
Collapse
Affiliation(s)
- Kate Muse
- School of Psychology, University of Worcester, Worcester WR2 6AJ, UK
- Correspondence:
| | - Emma Johnson
- Children’s Psychological Medicine, Oxford Children’s Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; (E.J.); (A.L.D.)
| | - Annabel L. David
- Children’s Psychological Medicine, Oxford Children’s Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; (E.J.); (A.L.D.)
| |
Collapse
|